Q. I

Am very distressed. I have two friends with AIDS that...

April 28, 1997|By Dr. Allan Bruckheim.

Q. I am very distressed. I have two friends with AIDS that have also been diagnosed with tuberculosis. Now they have another fight on their hands. Is this a common occurrence? Is there some special connection between these two diseases?

A. Any condition that significantly reduces the body's ability to fight infection can pave the way for tuberculosis. Typically this airborne disease attacks the lungs and is most prevalent in nursing homes and prisons, where close quarters can cause the germ to spread rapidly.

Likewise, infected city dwellers, including the homeless and a growing number of immigrants from countries where TB is endemic, add to the problem because they are unlikely to seek help, out of poverty or ignorance regarding the disease.

Approximately 10 million people in this country are infected with the TB germ. As the numbers of AIDS cases has increased, the statistics on tuberculosis have kept pace.

The increase is due to the tricky nature of the disorder: TB can be hard to detect, can mimic other conditions, takes proper care to cure and can come back, if not treated properly, long after the initial infection disappears.

In the elderly (as well as children under 5) the classic TB symptoms -- fever, night sweats, weight loss and bloody sputum -- are not always present. Those with TB receive a full course of treatment with effective anti-tuberculosis drugs.

For people infected with AIDS, the story can be much more grim. In fact, the inability to fight tuberculosis is often a person's first clue the AIDS virus is present.

Q. I am constantly plagued by fingernails that split and break. It hasn't always been this way, as I used to have beautiful nails and hands when I was a younger. It seems they really became worse after I married and moved from a warm climate in California to Montana, where winters are harsh. Do you think this may be the cause of my problem? If so, would you advise me to go back to California?

A. It is always nice to be in California, but I don't think returning there will solve your problems. There have been many explanations for the cause of brittle nails (onychoschizia), and research using an electron-scanning microscope has provided some interesting answers.

For some time, physicians were likely to blame women's frequent use of nail polishes, since women are affected by brittle nails about twice as often as men. Dermatologists at the University of Arkansas and the Alabama State University at Jacksonville, however, have pointed their fingers at a new culprit.

After experimenting with nail clippings taken from normal individuals, they found the greatest amount of nail splitting occurred in samples that had been alternately wetted and dried over a 14-day period. Mere soaking did not produce the same amount of damage.

Did washing dishes and clothing occur at the same time of your marriage and move? Examining this correlation might be the best answer.